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Objective@#To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis.@*Methods@#From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension.@*Results@#There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months.@*Conclusions@#The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.
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Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases (58 eyes) with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups:combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10％,the complication rate was 6.9％,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients (75.86 ％,24.14 ％ and 75.05 ± 0.28,respectively).The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant (P＜0.05).Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.
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Abstract?AIM: To comparatively analyze the efficacy and clinical value of cutting frontal muscular slap or not during frontalis aponeurosis flap suspension in treating congenital severe ptosis.?METHODS: Clinical data of 44 children ( 54 eyes ) with congenital severe ptosis treated in our hospital from May 2013 to October 2015 was retrospectively analyzed. Children included were divided into two groups according to the different ways of operation, observation group ( cutting frontal muscular slap ) and control group ( without cutting frontal muscular slap ) , 22 cases ( 27 eyes ) in each group. The general information, postoperative follow-up, eyelid closure and complication occurrence in two groups were compared.?RESULTS: The general information of the two groups had no statistical difference (P>0.05).After 1, 6mo, the cosmetic correction rate, the rate of overcorrection, and the rate of under correction in two groups had no statistical difference (P>0.05), but the activity of upper eyelid in observation group was bigger than that in control group (P0.05 ) , but eyelid fissure height in natural closed eyelids in control group was higher than that in observe group ( P<0.05 ).After 1mo, 2 eyes in control group were with abnormal feelings in frontal part, and 3 eyes in observation group.After 6mo, 2 eyes in control group were with abnormal feelings in frontal part, and 3 eyes in observation group.There were no complications such as exposure keratitis, eyelid margin deformity, infection, hematoma, and diplopia in two groups.?CONCLUSION: The total therapeutic effects of two different surgery procedures in treating severe congenital ptosis are quite similar.The surgery with cutting frontal muscular slap could improve the activity of upper eyelid and postoperative eyelid closure.
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Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence. Conclusion Compared with the traditional methods,this one may decrease the damage to the upper lid and frontalis area, leaving no risk of damaging the vessels or nerves. The technique is simple and the curative effect is affirmed. It can be used to treat any blepharoptosis patient with normal frontal muscle function.
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The frontal muscle is formed by a complex of contractile elements which compose the set of facial muscles responsible for the expression of emotions. In view of its functional characteristics the frontal muscle consists of a mixture of high (type I) and low oxidative (type II) muscle fibres. The objective of the present study was to determine the area, diameter, and relative volume occupied by each fibre type in frontal muscles of Norfolk rabbits using nicotinamide adenine dinucleotide tetrazolium reductase (NADH-TR) histochemistry combined with morphometry. In addition, the connective tissue area (endomysium) and the number of blood vessels per fibre were evaluated. Female rabbits ranging in age from 6 to 8 months and weighing 2.8 to 3.1 kg were used. Four quadrants of samples from 12 animals were analysed. Type IIB fibres occupied the largest area compared to the other fibre types. The fibre diameter and relative volume were similar among the different fibre types identified by NADH-TR staining. No significant difference in the number of vessels per fibre was observed between the different fibre types. The endomysial area occupied the smallest area among the parameters analyzed. These findings demonstrated the intense activity of this muscle in the facial architecture of the animal. However, the low oxidative type II fibres predomination indicates more prone to muscle fatigue. The present findings may contribute to the study of myopathies involving this muscle.
El músculo frontal está formado por un complejo de elementos contráctiles que componen el conjunto de músculos faciales responsables de la expresión de emociones. A la vista de las características funcionales, el músculo frontal está constituido de una mezcla de fibras musculares de alto (tipo I) y bajo nivel de oxidación (tipo II). El objetivo del presente estudio fue determinar área, diámetro y volumen relativo ocupado por cada tipo de fibra en los músculos frontales de conejos Norfolk utilizando histoquímica para nicotinamide adenina dinucleotide tetrazolium reductasa (NADH-TR), combinado con su morfología. Además, fueron evaluados la zona de tejido conectivo (endomisio) y el número de vasos sanguíneos por fibras. Fueron utilizados conejos hembras, de edades comprendidas entre los 6 a 8 meses y con un peso de 2,8 a 3,1 kg. Se analizaron cuatro cuadrantes de las muestras de 12 animales. Las fibras tipo IIB ocuparon la mayor superficie, en comparación con los otros tipos de fibras. Los diámetros y volúmenes relativos de las fibras fueron similares entre los diferentes tipos identificados por NADH-TR. No se observaron diferencias significativas en el número de vasos por fibra, entre los diferentes tipos de fibras. El área ocupada por el endomisio fue la superficie más pequeña entre los parámetros analizados. Estos resultados demostraron la intensa actividad de este músculo en la arquitectura facial del animal. Sin embargo, el predominio de las fibras tipo II, de baja oxidación, indica más propensión a la fatiga muscular. El presente hallazgo pueden contribuir al estudio de las miopatías con la participación de este músculo.